The Surgical Timeout: Why Your Surgeon Asks 'Which Side?' Before Surgery

You're about to go into the operating theatre, and the surgeon approaches and asks, 'Which knee—left or right?' Then marks your leg. This isn't a red flag. It's what good surgical care looks like. I've scrubbed in for hundreds of procedures as a surgical assistant. Every time, right before the first incision, we pause for a final safety check called a surgical timeout.

The Checklist Explained

Before any scalpel touches skin, everything stops. This is called a timeout—a brief safety pause developed by the World Health Organisation and used in operating theatres worldwide. Whether you're awake or asleep, someone says, 'Timeout, everyone.' The entire surgical team stops and huddles together. The theatre nurse holds the checklist. The anaesthetist looks up from their monitors. The technicians stop prepping.

The surgeon introduces everyone by name and role. Then the team confirms the patient's name, date of birth, procedure, and surgical site. We say 'correct side,' never 'right side'—because 'right' could mean either correct or the literal right side of the body. The distinction matters when you're holding a scalpel.

The team confirms the surgical site marking on your body. We confirm antibiotics were given. We check the equipment. Anyone on the team can lead this process—not just the surgeon. One person acts as scribe, ticking off each item. The whole process takes less than a minute.

Why It Matters - The Near Miss Reality

Wrong-site surgery is rare in hospitals with these protocols. Research on nearly 8,000 surgical patients across eight countries found that safety checklists reduced deaths by nearly half and complications by over a third.

The system works because it accounts for human nature. We all make mistakes under pressure. The timeout stops small errors before they become big problems.

This doesn't happen just once. Before you arrive, your surgeon reviews your case. At admission, a nurse verifies your identity and marks the surgical site while you're awake. Before anaesthesia, the anaesthetist confirms again. In the theatre, the entire team does the final check before incision.

Each checkpoint involves different people. What one person misses, another catches.

Surgical timeouts are standard practice in many hospitals across Australia, the US, UK, and Europe. But they're not yet universal. Access depends on hospital resources, training, and local safety culture.

If you don't witness a timeout before your surgery, you can ask: 'Will the team be doing a safety pause before my operation?' This question supports safety—it doesn't question competence.

Each time someone asks you to confirm your surgical site, they're adding a layer of safety. At admission. Before anaesthesia. In the operating theatre. Your participation matters. It's the final link in a system designed to keep you safe.

If you don't see a timeout? Ask for it. That's not rude—it's informed.